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Sunday, April 1, 2018

Bill to certify professional midwives passes Senate, but no time remains to pass it through the House by normal means

By Melissa Patrick and Al Cross
Kentucky Health News

FRANKFORT, Ky. -- A bill to give midwives professional recognition in Kentucky made it out of the Senate March 27 on a 29-8 vote, over opposition from doctors. It is all but dead, with only two days left in the legislative session, though the bill's sponsor refused to declare it so.

Sen. Tom Buford

"It's not too late, but as one might say, we are at the finish line and it will be close if it does," Sen. Tom Buford said in a telephone interview. "The General Assembly always has their barrels loaded until the last day after the veto session." Legislators' final day, Saturday, April 14, is scheduled to reconsider any legislation Gov. Matt Bevin may veto.

Since the legislature postponed its last pre-veto session day to Monday, April 2, it only has that day and the veto-override day left, and the constitution requires a bill to be read in a chamber on three separate days before passage. The House would have to add the bill's contents to a Senate bill pending in the House, pass it and return it to the Senate for final approval.

Kentucky has no rules or regulations for midwives. Buford's Senate Bill 134 would create a Certified Professional Midwife Advisory Council under the Kentucky Board of Nursing, which would be responsible for setting care standards for midwives to follow and issue permits to those who qualify.

Buford said Kentucky needs a law on midwifery "because you and I, believe it or not, we could go and be midwives tonight without any training or anything. That's a scary thought."

The Nicholasville Republican said opposition to the bill comes from the Kentucky Hospital Association and the doctors' lobby, the Kentucky Medical Association, even though he has tried to accommodate them with several changes to it. He said the groups voice safety concerns, but their opposition is more likely a "turf battle," adding that "it's usually about the money."

"Remember that a midwife might perform a home-birth delivery for free, or she might charge $3,000 to $6,000 -- and at a hospital, if everything goes right, it's $20,000 if you are in and out in two to three days with no complications," Buford said.

Mary Kathryn DeLodder, a leader of the Kentucky Home Birth Coalition, told the Senate Health and Welfare Committee March 19 that the coalition has been seeking the legislation since 2012. She said Kentucky has more than 700 home deliveries a year, and 33 states already have certified professional midwife programs.

"This bill is about increasing access to the only category of care providers who are clinically trained to attend births in the home settings, and that is the certified professional midwife," she said. She later added, "Families don't rely on Facebook groups to verify if their dentist or their pediatrician is legitimate, and they shouldn't have to do that for their midwife either. . . . Opposing this bill doesn't make anyone safer."

Buford told the Senate that his bill isn't about whether or not Kentucky will have home births, "because we are," he said. "This is a question of whether you want those home births to be safe. To be a somewhat certified individual that comes into that house, knows what they are doing."

Republican Sen. Ralph Alvarado, a Winchester physician who spoke strongly against the bill during the committee meeting, filed a floor amendment with a long list of conditions that would prohibit a certified midwife from attending a home birth, prohibit midwives from performing abortions and require them to have a transfer agreement with hospitals that deliver babies. Any violation of the law would result in a Class D felony.

Buford said afterward that if the legislation becomes law, the advisory council could add some of the same requirements in the "crushing amendment," but he would prefer to leave these decisions to the Board of Nursing and not allow "men to make the decision on how a woman will have a baby."

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Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.Republication of any KHN material with proper credit is hereby authorized, but if the republication is longer than a news brief we ask that it contain the first sentence of this paragraph. For our site that features articles of lasting importance, go here.